<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Order_receiving_status')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-order_receiving_status" class="form-control" name="row[order_receiving_status]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Personal_note')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-personal_note" class="form-control " rows="5" name="row[personal_note]" cols="50"></textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Communication_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-communication_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[communication_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Remuneration_details')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-remuneration_details" class="form-control " rows="5" name="row[remuneration_details]" cols="50"></textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Order_notice')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-order_notice" class="form-control " rows="5" name="row[order_notice]" cols="50"></textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Publication_works')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-publication_works" class="form-control " rows="5" name="row[publication_works]" cols="50"></textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Additional_remarks')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-additional_remarks" class="form-control " rows="5" name="row[additional_remarks]" cols="50"></textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Word_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-word_price" class="form-control" name="row[word_price]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Word_count')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-word_count" class="form-control" name="row[word_count]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Sort')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-sort" class="form-control" name="row[sort]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Wc_num')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-wc_num" class="form-control" name="row[wc_num]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Xs_num')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-xs_num" class="form-control" name="row[xs_num]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Min_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-min_price" class="form-control" name="row[min_price]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Max_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-max_price" class="form-control" name="row[max_price]" type="number" value="0">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
        </div>
    </div>
</form>
